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In the world of medical writing, it is unusual to find a writer that has the knowledge and skills necessary to excel in both science and business. While most medical writers only specialize in one of those aspects, the husband and wife team at Medical Communications Depot, Inc. uniquely encompass both skills sets, offering a broad range of exceptional services to their clients.

Company President Maria B. Vinall has been a publication specialist in the pharmaceutical industry for more than 10 years and possesses a diverse portfolio containing almost 3 decades of project management experience in various settings including business and education. Her sound business sense partnered with her interest in medicine and health economics make her a rare commodity in the medical writing business.

Her husband and company Vice President Phil E. Vinall has worked in the field of science and medicine for the entirety of his adult life. His research skills and publications, including clinical manuscripts and reviews, have received significant acclaim from the medical community.

The combination of this team’s business sense and extensive experience in science writing make MedComDepot the ideal medical writing company. You can be confident that the principals will personally be handling every aspect of your project from the technical to the business; outsourcing to another company is not part of our business practice.

To keep up with the evolving needs of their clients, MedComDepot is always adapting and expanding their capabilities. As part of their long term association with MD Conference Express®, MedComDepot covers many of the major medical meetings in the US and Europe. These conferences not only provide unique opportunities for their clients but they serve to keep the principals up-to-date on the latest medicine and science.

MedComDepot has the ability to meet all of the medical writing needs and publication planning that your company is seeking. Our diverse educational and professional background and commitment to service has placed us among the most successful of the small medical writing companies.

To get more information on our services or request writing samples, contact us here.

A microbiota is a collection of microbial species that form a community. A microbiome is the collection of genes present in the genomes of that community. I was first introduced to the subject of micobiota at a conference on Digestive Diseases in 2010 during which one of the speakers presented some of the early findings from the Human Microbiome Project (HMP). The HMP was established by the National Institutes of Health to characterize microbial communities in the human body and to look for correlations between changes in the microbiome and human health.

The microbial cells in the human body form an ecological community of commensal, symbiotic, and pathogenic microorganisms that share our body.Although we are all born germfree by the time we reach adulthood the microbial cells in our body with outnumber the human cells by about 10 to 1. The average human gut contains about 100 different species of microbes, which re not only not harmful but necessary to maintaining health.

The human microbiota is made up of a particular set of microbes thatcomplement each other. Its exact composition varies from person to person and it is now believed that the microbiota may have a significant impact on health and disease. Studies have identified potential connections with obesity, diabetes, rheumatoid arthritis, muscular dystrophy, multiple sclerosis, and perhaps some cancers and brain pathologies. In healthy individuals the microbiota provides a wide range of metabolic functions that humans lack such as fermenting unused energy substrates, training the immune system, preventing growth of harmful, pathogenic bacteria, regulating the development of the gut, producing vitamins (biotin and vitamin K) for the host, and producing hormones to direct the host to store fats.In return, the host provides a protected, nutrient-rich environment in which the microbiota can thrive

Between 300 and 1000 different species of microbes, such as fungi, protozoa, and archaea, live in the human gut.The relationship between diet, age, host physiology, and genotype can affect the composition of an individual’s microbiota. An imbalance can lead to disease;balance to better health.

Gut microbes can influence nutrient uptake, energy regulation, and ultimately, weight and metabolic disorders such as obesity, Type 2 diabetes, and low-levels of inflammation. Evidence suggests that differences in the gut microbiome exist between obese and lean humans, while composition can change rapidly in response to dietary factors. A propensity for obesity in some individuals may be traced to the mother who influences the original inoculum and subsequent development of the infant microbiota. Data has shown that infant fecal composition is related to weight and the weight gain of their mothers during pregnancy. Thus, modification of the gut microbiota by dietary modification may be a relevant therapeutic avenue for obesity and other metabolic disorders during pregnancy.

Analysis of fecal samples in humans has also revealed a potential link between obesity and alterations in the gut flora. Obese individuals have fewer Bacteroidetes and more Firmicutes bacteria than lean controls.In one study, the percentage of weight loss was related to the amount of Bacteroidetes increase and Firmicutes decrease. Other studies have shown a relationship between diet restrictions, use of probiotics, high fat/fiber versus low fat/fiber diets, and weight loss surgery on gut flora composition independent of obesity. It is also known that Bifidobacterium numbers are higher and Staphylococcus aureus levels are lower in children who exhibited normal weight compared with children who became overweight.

Research is being directed toward finding probiotics that beneficially modulated human gut microbiota using either a microbiome exhibiting antiobesity effects and/or the right substrate (prebiotic) to promote its growth to restore the microbiota to a healthy state.

When you run your own medical writing business, you are either writing or working on getting new business. As most freelancers know, it’s a full-time job and vacations are way down on the list of things to do. Since leaving big pharma Maria and I have wished we could find a way to take advantage of the freedom that having our own business can bring. In 2011we decided to go beyond working from a home office.

We normally work out of an office attached to our residence. Although the house is located in the beautiful countryside of Chester County, Pennsylvania, like most constants, it gets old. When we first started Medical Communications Depot we traveled frequently covering medical conferences. In addition to our US travels, we generally got to Europe at least once a year. Cutbacks in the industry and improvements in technology now allow us to do much of this work without setting foot in the conference hall. While this was a blessing in some respects,it has led to us spending more time staring at our computer screens at home.

The great thing about writing, any type of writing, is you can do it anywhere. Our equipment consists of our laptops, an IPad, a couple of Microsoft Surfaces, and our iPhones. The only other thing we need is an internet connection–something that you can get just about anywhere these days.

We started by checking out Vacation Rentals by Owner®, a web service where you can view and rent properties anywhere in the world. You negotiate directly with the owner, not the service. We have used them numerous times with great success both for personal and business travel. The property descriptions are detailed and most owners are only too happy to answer lingering questions. The difficulty is the plethora of properties and locations from which to choose.

Portugal
We had spent some time in Portugal many years ago and had always yearned to return, so for our first foray into working away from the office we rented a two-bedroom house in Penedo, Portugal for the month of October. The web pictures underestimated the beauty of the place, which was located high in the hills surrounding Sintra overlooking a picturesque typical Portuguese village. We had a view of the ocean out back and Penedo Palace out front.

To avoid looking like pack animals while lugging our equipment and slowing our TSA screening to boot, we decided to check our equipment. With the new regulations, it cost a bit more but it was worth it. We bought a metal case to pack the computers and accessories and were glad we did as they took a beating going through the baggage process. On arriving in our new temporary home, we immediately set up shop at a large table in the dining area. We came with work from a client on the east coast but we were also able to take the opportunity tomake a few new European connections. One of our skill sets is conference coverage and there were 2 conferences in Lisbon (about 30 minutes by train) during our stay. We worked in the morning before US business commenced and then took a little recreational time in the early afternoon. When we returned in the late afternoon/early evening, we could still handle client issues e-mailed to us that day. This worked well and we were able to experience a lot of the local culture, including the numerous beaches within easy driving distance. The temperature was in the high 60s, so sitting on the beach was still an option. We had no problem completing our assignments and getting them in on time. In fact, had we not told them our clients would not have known we were a continent away.

What we learned. It was a wonderful get-away. A month is just the right amount of time—long enough to feel connected to your surroundings, but also enough to start to feel a little homesick. The house was perfect; it had a great kitchen, a wonderful out-of-the way location, helpful owners who lived on the property and were always ready to make life easier, and quick access to all that defines Portugal. The experiment was a bit pricey, however. While we could walk to the store in the village to buy eggs, bread, cheese, and wine, and there was a small café and restaurant, if we wanted anything more exotic, a car was necessary. The car ate up a big hunk of our income what with the additional insurance needed to cover the risk of driving on the narrow roads to get to our place and the European gas prices. In addition, our rent, while fair for the house, was a bit pricey. These 2 major expenses combined with the approximate 30 cents per dollar loss due to the exchange rate hit hard. Taxes on food and other items averaged about 13%. When all was said and done, we lost money that month, but we had a great time and we learned a lot about how to do it better next time. We decided to stay away from Europe for a while but with the improving exchange rate we are reconsidering that decision. We will, however, continue to look for places that don’t require a car all of the time.

PanamaPanama was all that we imagined it to be and more. With a house right on the beach, Pacific side, in the middle of country, we were a long way from nowhere. El Palmar was not exactly the easiest place to work as walking on the beach or soaking in the pool was always an inviting option. Despite these distractions, we did manage to get some work done. Even in this small surfer town we had excellent internet service and were able to Skype™ when we needed.

Panama was significantly cheaper than Portugal. They use the American dollar and the prices for basics were equivalent to the US. Local food was even cheaper. We were there from mid-February to mid-March 2013. The weather was perfect with temperatures in the mid-90s during the day and mid-80s at night. Because we were in the “dry arc” there was virtually no rain, quite bearable humidity, and no mosquitos. We rented a car for day trips, but did not travel too far afield. The house and surroundings were so perfect; we saw little need to go anywhere else.

Panama is in the midst of a tremendous economic boon. Construction is everywhere. They are expanding the Panama Canal to handle larger tankers and cruise boats. Driving in Panama City is about the same as any big city. When we were there it was particularly trying since construction of a subway system (the first in Lain America) and a high-speed rail service from the airport as well as renovation of the Casa Antigua were all in progress. A new international airport is also being built Río Hato, Panama much nearer to the beaches and about 2 hours from Panama City. Río Hato Airport(also known as Scarlett Martinez International Airport) was used by the United States Army as part of the defense of the Panama Canal. It was closed as an active Air Force facility in 1948 but was used as an auxiliary military landing field as recently as 1990.

The Panamanian government offers many incentives for businesses and retirees to relocate. Along the Pacific coast condominiums are going up everywhere and there are many retired Canadians and Americans living here. There is a real feeling of excitement and growth in Panama and if I were a young man, I would think seriously about locating my business there. The Panamanian people are friendly and we did not fine crime to be a problem. Another plus, Panama is never hit by hurricanes

Taboga Island
In November of 2014 we rented a small apartment in a lovely villa on Taboga Island, a volcanic, tropical island in the Gulf of Panama that is about 30 minutes or 12 miles by boat from Panama City. Taboga has a coastal perimeter of about 8 miles and a population of about 1200 to 1500. There are only a very few small cars on the island. Transportation occurs mainly by walking or golf cart.

Taboga was discovered in the 16th century Vasco Núñez de Balboa. Its name derives from an Indian word that means many fish (aboga). Pirates, including the infamous Henry Morgan and Francis Drake, used the island as a stopping point. Paul Gauguin stayed there during 1887. The Catholic church of San Pedro is thought to be the second oldest church in the Western Hemisphere.

Villa Caprichosa, where we stayed, has been featured in a number of designer magazines. It was designed by its owner Diane Burn to feel like an 18th-century European villa. From the terrace outside our apartment we could watch the freighters stack up waiting their turn to pass through the Panama Canal and the visitors arrive by ferry at the town dock.

The temperature and humidity during our visit were sometimes uncomfortable but we did have air conditioning. Of the 12 days we spent on Taboga we spent four parked in front of our computers. Even here on this small island we had good internet and phone service. The cost of living (although still low) is bit higher than on the mainland since all supplies are shipped over by boat. There weren’t too many places to spend money however.We counted three or four restaurants with sporadic hours, a few small beach bars, and the two local mercados. Luckily our hostess had suggested that we bring a few things with us and she was gracious enough to pick up some supplies on her own trips to the mega grocery stores on the mainland.

Days on the island were long and easy. The island was small enough that we eventually met most of the resident expats—a welcoming and eclectic group with lots of interesting stories to tell. On Holidays and weekends, the island population increases significantly as many Panamanians from the city take the ferry over for some sun and fun on the beach. The bay also becomes crowded with large yachts and party people. We were on Taboga over the Thanksgiving Holiday and our hostess arranged for us to be invited to a traditional (sort of) Thanksgiving Dinner in the Casco Viejo. Dinner was held in a beautiful recently renovated building soon to open as restaurant and was sponsored by a group of American expats who are heavily involved in the revitalization of this part of the city. We took the ferry over on Thursday morning and explored the old city before going to dinner. There were perhaps 100 guests—all Americans living in various parts of Panama. As we have found with everyone who lives in Panama, they were excited to talk about their adopted country and why they chose this particular area to live. On Friday we re-visited El Palmar (the town we stayed in during our first visit to Panama) before returning for the 4:30 PM “fast boat.”

Panama holds a special place for us and we hope to return many more times.

Ecuador
For 2015,have rented a beach house on the coast nearCanoa, Ecuador in April (2015). The monthly rental for this 4-bedroom house is far cheaper than a similar place for a week on the Jersey shore. The cost of living is cheap and like Panama, Ecuador uses the US dollar as currency. April is normally a busy month for us. It will be difficult to skip the beach to stay inside and work. As I write this, it is 810 in Canoa and 240in West Chester, PA, where we live. Will update you on our return.

Of the dozens of conferences we cover each year, almost all have at least one presentation on the potential of gene therapy, regardless of the conference topic. Gene therapy is being studied to correct immunodeficiency diseases, diabetes, cancer, heart disease, and a myriad of other conditions. While many gene therapy clinical trials are currently under way worldwide (Clinical Trials.gov lists 3817 such trials), the Food and Drug Administration has not yet approved any human gene therapy product for use in the US.

Gene therapy is different from traditional drug-based approaches, which may treat symptoms but not the underlying genetic problems. The purpose of gene therapy is to correct a defective or mutated gene that can result in malfunctioning or missing proteins leading to disease. Approaches may involve replacing a mutated gene with a normal functioninghealthy one, inactivating a mutated gene, or introducing a new gene to provide added function to the existing disease fighting mechanisms. In most cases, a carrier or vector is used to deliver the gene into the cell. Virus vectors that attach to the host cell and release the genetic material into the cell areused most often.It is also possible to remove cells from the patient, expose them to the vector in a laboratory environment, and thenreturn them to the patient where they make a functioning protein. Commonly used virus vectors include adenoviruses, adeno-associated viruses (AAV), retroviruses, and the herpes simplex virus.Virus vectors may increase the risk of inflammation and organ failure, infect untargeted cells, and lead to tumor formation. Non-viral gene delivery methods may also be used, but are limited by their low gene transfer efficiency. They are relative safe, however, have low immunogenicity, and lack DNA insert-size limitations.

Current gene therapy approaches target either bone marrow or blood cells (body cells) in which case the changes are not passed on to future generations or egg and sperm cells (germ cells) that allow the changes to be passed on to futuregenerations. The latter type of therapy is prohibited in many countries due to ethical and technical concerns. Gene therapy is more effective when the condition being corrected involves one or only a few known genes, while diseases involving many genes and environmental factors are not good candidates.

One example of gene therapy is the use of a gene called p53 that normally prevents tumor growth. Missing or defective p53 is linked to several types of cancer and it has been hypothesized that re-introducing a functioning p53 gene into the body will causecancer cells to die. In one study, a modified version of the herpes simplex 1 virus injected directly in a cancerous tumor has been shown to be effective against melanoma. In another study, immune cells from patients with leukemia treated with a virus that genetically altersthe cells to recognize a protein that sits on the surface of the cancer cell resulted in complete remission in 26 patients.

Beta-thalassemia, an inherited blood disorder, can result in series of life threatening events beginning with severe anemia. This creates the need for repeated blood transfusions that can lead to iron toxicity, diabetes, liver damage, and heart failure. In one new approach, blood stem cells extracted from the patient are treated with a functioning version of the defective gene then reintroduced into the patient using a retrovirus to transfer a functioning copy of the beta-globin gene (codes for an oxygen-carrying protein in red blood cells). The result has been reduced or no transfusions for the patients. A similar approach is being anticipated for treating patients with sickle cell disease.

Severe combined immune deficiency (SCID) and adenosine deaminase (ADA) deficiency are two inherited immune disorders that have been treated with gene therapy. A common method is to remove blood stem cells from patients, treat the cells with a retroviral vector to deliver a functional copy of the defective gene, and then return the stem cells to the patient. By treating the cells outside the patient’s body, only the desired target cells are attacked by the virus.

Gene therapies are being developed to treat several types of inherited blindness using vectors based on AAV.This vector has also been used to treat people with hemophilia to deliver a gene for the missing protein Factor IX, needed for clot formation. AAV has also been used to deliver a working copy of the lipoprotein lipase (LPL) gene to muscle cells. LPL genes code for a protein that helps breakdown fat in the blood, preventing fat concentrations from rising to toxic levels.

It has been 20 years since the first gene therapy trial and work continues. Despite progress, very few patients have received any effective gene-therapy treatments. Yet, we are moving toward a period when routine genome (all the information needed to build and maintain each individual) sequencing of newborns may be part of neonatal care that will be integrated into future personalized medical treatment. Gene therapy offers great promise for novel genetic treatments that, when perfected, will likely outperform current treatment methods.